U.S. patent application number 17/099197 was filed with the patent office on 2021-05-27 for surgical device for treatment of endometriosis.
The applicant listed for this patent is GYRUS ACMI, INC. D/B/A OLYMPUS SURGICAL TECHNOLOGIES AMERICA, GYRUS ACMI, INC. D/B/A OLYMPUS SURGICAL TECHNOLOGIES AMERICA. Invention is credited to Thomas J. Holman, Nikhil M. Murdeshwar.
Application Number | 20210153899 17/099197 |
Document ID | / |
Family ID | 1000005274167 |
Filed Date | 2021-05-27 |
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United States Patent
Application |
20210153899 |
Kind Code |
A1 |
Holman; Thomas J. ; et
al. |
May 27, 2021 |
SURGICAL DEVICE FOR TREATMENT OF ENDOMETRIOSIS
Abstract
Surgical instruments and methods are disclosed including a
tissue removal tool for treatment of endometrial tissue on a
background tissue of a patient. The tissue removal tool can
optionally comprise a graspable portion, a shaft and an end
effector. The shaft can be coupled to the graspable portion. The
shaft can have a proximal portion and a distal portion and can be
configured to access an anatomic location of the endometrial
tissue. The end effector can be coupled to the distal portion of
the shaft. The end effector can be configured to lift the
endometrial tissue relative to the background tissue to a lifted
position. The end effector can be configured to cut the endometrial
tissue from the background tissue with the endometrial tissue in
the lifted position.
Inventors: |
Holman; Thomas J.;
(Princeton, MN) ; Murdeshwar; Nikhil M.; (Maple
Grove, MN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
GYRUS ACMI, INC. D/B/A OLYMPUS SURGICAL TECHNOLOGIES
AMERICA |
Southborough |
MA |
US |
|
|
Family ID: |
1000005274167 |
Appl. No.: |
17/099197 |
Filed: |
November 16, 2020 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
62941079 |
Nov 27, 2019 |
|
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|
Current U.S.
Class: |
1/1 |
Current CPC
Class: |
A61B 2017/320052
20130101; A61B 2217/005 20130101; A61B 2017/320075 20170801; A61B
2017/00867 20130101; A61B 2017/4216 20130101; A61B 17/4241
20130101; A61B 17/320016 20130101 |
International
Class: |
A61B 17/42 20060101
A61B017/42; A61B 17/32 20060101 A61B017/32 |
Claims
1. A tissue removal tool for treatment of endometrial tissue on a
background tissue of a patient, the tissue removal tool comprising:
a graspable portion; a shaft coupled to the graspable portion, the
shaft having a proximal portion and a distal portion and configured
to access an anatomic location of the endometrial tissue; and an
end effector coupled to the distal portion of the shaft, wherein
the end effector is configured to lift the endometrial tissue
relative to the background tissue to a lifted position, and wherein
the end effector is configured to cut the endometrial tissue from
the background tissue with the endometrial tissue in the lifted
position.
2. The tissue removal tool of claim 1, wherein the end effector is
movable relative to the shaft to interface with the background
tissue about the endometrial tissue.
3. The tissue removal tool of claim 2, wherein the end effector is
movable about at least an axis transverse to a longitudinal axis of
the shaft.
4. The tissue removal tool of claim 1, wherein the end effector is
configured to cut the endometrial tissue from the background tissue
by receiving the endometrial tissue within a cavity of the end
effector.
5. The tissue removal tool of claim 1, wherein the end effector is
configured to cut in a plane that is substantially parallel with a
surface of at least one of the background tissue or the endometrial
tissue.
6. The tissue removal tool of claim 1, wherein the end effector is
configured as a suction port to lift the endometrial tissue by
gathering.
7. The tissue removal tool of claim 1, wherein the end effector is
configured as a shape memory element to lift the endometrial tissue
by grasping.
8. The tissue removal tool of claim 1, wherein the end effector is
configured to cut the endometrial tissue in a direction transverse
to a direction in which the end effector is configured to lift the
endometrial tissue.
9. An end effector of a tissue removal tool for treatment of
endometrial tissue on a background tissue of a patient, the end
effector comprising: an actuator configured to gather the
endometrial tissue relative to the background tissue; and a blade
configured to cut the endometrial tissue with the endometrial
tissue gathered from the background tissue, wherein the blade cuts
in a plane that is in a range of between about 45 degrees and about
135 degrees, inclusive, to a direction in which the actuator
gathers the endometrial tissue.
10. The end effector of claim 9, wherein the actuator comprises a
shape memory element to gather the endometrial tissue.
11. The end effector of claim 9, wherein the actuator comprises a
vacuum configured to gather the endometrial tissue.
12. The end effector of claim 9, further comprising a shaft of the
cutting tool, wherein the end effector is movable relative to the
shaft to interface with the background tissue about the endometrial
tissue.
13. The end effector of claim 9, wherein the blade is configured to
cut the endometrial tissue from the background tissue in a
direction that is substantially transverse to the direction in
which the actuator gathers the endometrial tissue with the
endometrial tissue received within a cavity of the end
effector.
14. The end effector of claim 9, wherein the tissue cutting element
is configured to cut the endometrial tissue in a direction that is
substantially transverse to a direction the actuator is configured
to lift the endometrial tissue.
15. The end effector of claim 9, wherein the actuator is configured
to gather the endometrial tissue in a direction that is in a range
of between about 45 degrees and about 135 degrees, inclusive, to
one of the background tissue or a longitudinal axis of the end
effector.
16. A method of treating endometrial tissue at an anatomical
location, the method comprising: guiding an end effector to the
anatomical location; lifting the endometrial tissue relative to a
background tissue with the end effector; and cutting the
endometrial tissue from the background tissue with the end effector
and with the endometrial tissue lifted from the background
tissue.
17. The method of claim 16, wherein cutting endometrial tissue is
in a direction transverse to a direction of the lifting the
endometrial tissue.
18. The method of claim 16, further comprising manipulating the end
effector to interface with the background tissue.
19. The method of claim 16, wherein lifting the endometrial tissue
comprises gathering the endometrial tissue with suction or a shape
memory element.
20. The method of claim 16, wherein lifting the endometrial tissue
comprises grasping the endometrial tissue with a shape memory
element.
Description
CROSS-REFERENCE TO RELATED APPLICATION
[0001] This application claims the benefit of priority to U.S.
Provisional Patent Application Ser. No. 62/941,079, filed Nov. 27,
2019, the contents of which are incorporated herein in their
entirety.
TECHNICAL FIELD
[0002] This document pertains generally, but not by way of
limitation, to surgical devices, and more particularly, to a device
having a tissue removal tool for removing endometrial tissue.
BACKGROUND
[0003] Many surgical devices have an end effector. Indeed, an end
effector is often used for surgical procedures such as laparoscopic
procedures and endoscopic procedures. End effectors are generally
used to manipulate, engage, grasp, or otherwise interact with
anatomical features, such as a vessel or other tissue.
[0004] Endometriosis is a condition where tissue that normally
lines the inside of the uterus, the endometrium, grows outside the
uterus. Often, endometriosis occurs in and around the abdomen, such
as near the ovaries, fallopian tubes, and other tissue lining of
the abdomen. In some cases, endometrial tissue can spread beyond
tissue of the reproductive system to the urinary tract, for
example. Endometriosis can include shallow endometrial tissue in
and around these areas, and/or deeper endometrial tissue. The
condition can be particularly painful as the endometrial tissue
outside the uterus continues to behave in the manner of endometrial
tissue within the uterus during the menstrual cycle by thickening,
breaking-down and bleeding.
Overview
[0005] Because of the variety of locations for endometrial tissue
growth and the variety of thicknesses and behaviors of endometrial
tissue, there is a need for improved treatment of endometriosis,
for example, by improvement in the surgical devices, and in
particular, the end effector used to treat endometrial tissue.
[0006] The present inventors have recognized, among other things,
that the foregoing problems can be addressed by tissue removal
tools for endoscopic or laparoscopic treatment of endometrial
tissue as disclosed herein. More particularly, the present
inventors have recognized various tissue removal tools that can
lift (for example, at least partially separate, at least partially
delineate) endometrial tissue from background tissue prior to
cutting the endometrial tissue.
[0007] Example 1 is a tissue removal tool for treatment of
endometrial tissue on a background tissue of a patient. The tissue
removal tool can optionally comprise a graspable portion, a shaft
and an end effector. The shaft can be coupled to the graspable
portion. The shaft can have a proximal portion and a distal portion
and can be configured to access an anatomic location of the
endometrial tissue. The end effector can be coupled to the distal
portion of the shaft. The end effector can be configured to lift
the endometrial tissue relative to the background tissue to a
lifted position. The end effector can be configured to cut the
endometrial tissue from the background tissue with the endometrial
tissue in the lifted position.
[0008] Example 2 is the tissue removal tool of Example 1, wherein
the end effector can be movable relative to the shaft to interface
with the background tissue about the endometrial tissue.
[0009] Example 3 is the tissue removal tool of Example 2, wherein
the end effector can be movable about at least an axis transverse
to a longitudinal axis of the shaft.
[0010] Example 4 is the tissue removal tool of any one or
combination of Examples 1-3, wherein the end effector can be
configured to cut the endometrial tissue from the background tissue
by receiving the endometrial tissue within a cavity of the end
effector.
[0011] Example 5 is the tissue removal tool of any one or
combination of Examples 1-4, wherein the end effector can be
configured to cut in a plane that is substantially parallel with a
surface of at least one of the background tissue or the endometrial
tissue.
[0012] Example 6 is the tissue removal tool of any one or
combination of Examples 1-5, wherein the end effector can be
configured as a suction port to lift the endometrial tissue by
gathering.
[0013] Example 7 is the tissue removal tool of any one or
combination of Examples 1-5, wherein the end effector can be
configured as a shape memory element to lift the endometrial tissue
by grasping.
[0014] Example 8 is the tissue removal tool of any one or
combination of Examples 1-7, wherein the end effector can be
configured to cut the endometrial tissue in a direction that can be
transverse to a direction in which the end effector is configured
to lift the endometrial tissue.
[0015] Example 9 is an end effector of a tissue removal tool for
treatment of endometrial tissue on a background tissue of a
patient. The end effector can optionally comprise an actuator and a
blade. The actuator can be configured to gather the endometrial
tissue relative to the background tissue. The blade can be
configured to cut the endometrial tissue with the endometrial
tissue gathered from the background tissue. The blade can cut in a
plane that is in a range of between about 45 degrees and about 135
degrees, inclusive, to a direction in which the actuator gathers
the endometrial tissue.
[0016] Example 10 is the end effector of Example 9, wherein the
actuator can comprise a shape memory element to gather the
endometrial tissue.
[0017] Example 11 is the end effector of Example 9, wherein the
actuator can comprise a vacuum configured to gather the endometrial
tissue.
[0018] Example 12 is the end effector of any one or combination of
Examples 9-11, further optionally comprising a shaft of the cutting
tool, wherein the end effector can be movable relative to the shaft
to interface with the background tissue about the endometrial
tissue.
[0019] Example 13 is the end effector of any one or combination of
Examples 9-12, wherein the blade can be configured to cut the
endometrial tissue from the background tissue in a direction that
can be substantially transverse to the direction in which the
actuator gathers the endometrial tissue with the endometrial tissue
received within a cavity of the end effector.
[0020] Example 14 is the end effector of any one or combination of
Examples 9-13, wherein the tissue cutting element can be configured
to cut the endometrial tissue in a direction that can be
substantially transverse to a direction the actuator is configured
to lift the endometrial tissue.
[0021] Example 15 is the end effector of any one or combination of
Examples 9-14, wherein the actuator can be configured to gather the
endometrial tissue in a direction that can be in a range of between
about 45 degrees and about 135 degrees, inclusive, to one of the
background tissue or a longitudinal axis of the end effector.
[0022] Example 16 is a method of treating endometrial tissue at an
anatomical location. The method can optionally comprise: guiding an
end effector to the anatomical location; lifting the endometrial
tissue relative to a background tissue with the end effector; and
cutting the endometrial tissue from the background tissue with the
end effector and with the endometrial tissue lifted from the
background tissue.
[0023] Example 17 is the method of Example 16, wherein cutting the
endometrial tissue can be in a direction transverse to a direction
of the lifting the endometrial tissue.
[0024] Example 18 is the method of any one or combination of
Examples 16-17, optionally further comprising manipulating the end
effector to interface with the background tissue.
[0025] Example 19 is the method of any one or combination of
Examples 16-18, wherein lifting the endometrial tissue can comprise
gathering the endometrial tissue with suction or a shape memory
element.
[0026] Example 20 is the method of any one or combination of
Examples 16-18, wherein lifting the endometrial tissue can comprise
grasping the endometrial tissue with a shape memory element.
[0027] Example 21 is any one or any combination of the elements of
Examples 1-20.
[0028] This overview is intended to provide an overview of subject
matter of the present patent application. It is not intended to
provide an exclusive or exhaustive explanation of the invention.
The detailed description is included to provide further information
about the present patent application.
BRIEF DESCRIPTION OF THE DRAWINGS
[0029] In the drawings, which are not necessarily drawn to scale,
like numerals may describe similar components in different views.
Like numerals having different letter suffixes may represent
different instances of similar components. The drawings illustrate
generally, by way of example, but not by way of limitation, various
examples discussed in the present document.
[0030] FIG. 1 is a schematic view of a first example of a tissue
removal tool that can be used in a laparoscopic or open procedure
according to the present application.
[0031] FIG. 2A is a side view, in partial cross-section,
illustrating a first end effector of the tissue removal tool of
FIG. 1 configured for removing endometrial tissue from a background
tissue with a blade thereof in a first retracted position according
to an example of the present application.
[0032] FIG. 2B is another side view, in partial cross-section of
device of FIG. 2A with a blade in a second extended position to cut
and remove the endometrial tissue from the background tissue
according to an example of the present application.
[0033] FIG. 3A is a side view, in partial in cross-section,
illustrating a second end effector of the tissue removal tool of
FIG. 1 configured for removing endometrial tissue from a background
tissue with a blade thereof in the first retracted position
according to an example of the present application.
[0034] FIG. 3B is another side view, in partial cross-section of
the device of FIG. 3A with a blade in a second extended position to
cut and remove the endometrial tissue from the background tissue
according to an example of the present application.
[0035] FIG. 4A shows a schematic view of another example of a shape
memory element in an undeformed state positioned adjacent
background tissue and endometrial tissue according to an example of
the present application.
[0036] FIG. 4B shows a schematic view of the shape memory element
of FIG. 4A in a deformed state and re-positioned relative to the
background tissue and endometrial tissue according to an example of
the present application.
[0037] FIG. 5A shows a schematic view of another example of a shape
memory element in ail undeformed state positioned adjacent
background tissue and endometrial tissue according to an example of
the present application.
[0038] FIG. 5B shows a schematic view of the shape memory element
of FIG. 5A in a deformed state grasping the endometrial tissue
according to an example of the present application.
[0039] FIG. 6A shows a schematic view of another example of a shape
memory element in an undeformed state positioned adjacent
background tissue and endometrial tissue according to an example of
the present application.
[0040] FIG. 6B shows a schematic view of the shape memory element
of FIG. 6A in a deformed state grasping the endometrial tissue
using fingers and slots according to an example of the present
application.
DETAILED DESCRIPTION
[0041] The present disclosure is directed to a surgical device such
as a cutting tool that can allow a surgeon to operate an end
effector to perform such cutting. It is contemplated that the terms
"lift" or "lifting" as used herein does not connote use of movement
in a reference direction such as a gravitational direction. Rather,
the terms "lift" or "lifting" as used herein means to manipulate a
position such as to at least partially separate or at least
partially delineate a target tissue such as endometrial tissue from
a background tissue. As further disclosed herein "lift" or
"lifting" can be performed by grasping, gathering, pulling or
otherwise manipulating a position of the target tissue (e.g.,
endometrial tissue) as further discussed herein. The "lift" or
"lifting" need not be in a direction transverse to background
tissue. Rather, the "lift" or "lifting" can be in any direction
such as, but not limited to between 45 and 135 degrees, inclusive
of a longitudinal axis of the end effector or of a surface of the
background tissue. The "lift" or "lifting" can be performed so as
to least partially separate or at least partially delineate the
target tissue such as endometrial tissue from the background
tissue.
[0042] In this disclosure, relative terms, such as, for example,
"about", "generally", or "substantially" are used to indicate a
possible variation of .+-.10% in a stated numeric value or within
.+-.10.degree. of the numeric value.
[0043] FIG. 1 is a schematic diagram of a laparoscopic surgical
procedure being performed with a tissue removal tool 100. Elements
of FIG. 1 are not drawn to scale for illustrative purposes. The
procedure of FIG. 1 is illustrated as a laparoscopic procedure but
the tissue removal tool 100 alternatively can be utilized in an
open or endoscopic procedure, for example.
[0044] The surgical procedure of FIG. 1 can be performed to remove
or otherwise abate target tissue such as endometrial tissue that is
diseased or invasive. FIG. 1 illustrates a surgical procedure being
performed to remove endometrial tissue from the cavity of abdomen A
that has grown outside of uterus U. However, the instruments and
methods of the present application can be used to perform other
procedures, such as to remove target tissue such as cysts, polyps,
abscesses, fibroids, tumors, lymph node tissue, etc.
[0045] FIG. 1 illustrates an operating room environment where the
tissue removal tool 100 can be used with a laparoscope 102 and can
be coupled to or used in conjunction with a camera 104 and display
106. The patient can be appropriately anesthetized during the
procedure. As shown in FIG. 1, an incision 108 can be made in
abdomen A of the patient. The incision 108 can be a minimally
invasive incision sized to receive the laparoscope 102 and cutting
tool 100. However, the incision 108 can alternatively be an
incision having a sufficient length to form a portal for performing
an open procedure using the cutting tool 100.
[0046] The tissue removal tool 100 can be inserted into the
incision 108. The tissue cutting device 100 can be coupled to the
camera 104 for viewing tissue within abdomen A of the patient
internal to incision 108. Camera 104 can be configured to be used
in conjunction with various visualization techniques such as, but
not limited to UV, contrast, dye, etc. to better visualize the
target tissue (e.g., the endometrial tissue). The tissue of uterus
U, bladder B, ovaries O and other locations and organs, such as
fallopian tubes and the rectum, can be identified using the camera
104, for example.
[0047] The tissue removal tool 100 can also be coupled to or
otherwise used with a device 112 such as a vacuum or generator
according to some examples for purposes discussed subsequently. The
tissue cutting device 100 can include one or more passages 114 that
extends through incision 108 to allow access to internal tissue of
the patient from outside the patient.
[0048] The tissue removal tool 100 having an end effector 101 (as
further illustrated and described) can be inserted into incision
108. For example, the end effector 101 of the tissue removal tool
100 can be inserted into one of the one or more passages 114 of the
laparoscope 102. Specifically, a shaft 116 of the tissue removal
tool 100 can be inserted through the one of the one or more
passages 114 such that the end effector 101 protrudes from the one
of the one or more passages 114 and is located inside abdomen
A.
[0049] A light emitting device 118 can also be positioned within
abdomen A. Light can be generated by a light source to be emitted
by the light emitting device 118 into the cavity abdomen A. The
light source and/or the light emitting device 118 can be attached
to the surgical instrument. The light can be white light or UV
light to visually aid viewing of tissue. The light can additionally
be light of a wavelength sufficient to energize, e.g., fluoresce,
dye, such as near-infrared (NIR) light. NIR light can be used to
energize indocyanine green in endometriosis surgeries, for example.
Further details regarding the construction of the light emitting
device 118 can be found in co-filed U.S. Provisional Patent
Application No. 62/940,328, entitled "SURGICAL INSTRUMENTS WITH
INTEGRATED LIGHTING SYSTEMS", filed Nov. 26, 2019, the
specification of which is incorporated by reference in its
entirety.
[0050] The target tissue (e.g., here endometrial tissue indicated
as "ET") can be identified or differentiated from background tissue
"BT" by the light and/or various known methods including dye,
contrast, etc. and can be treated with the tissue removal tool 100
as further discussed herein. For example, light L emitted within
the abdomen A can pass around the end effector 101 to illuminate
tissue on ovary O. The tissue removal tool 100 can have a graspable
portion 121 in addition to the shaft 116. The shaft 116 can be
coupled to the graspable portion at a proximal portion thereof. The
end effector 101 can be coupled to a distal portion of the shaft
116. The tissue removal tool 100 can also include a first actuator
120 such as a lever, trigger, button or valve operable to lift the
endometrial tissue ET and a second actuator 122 such as a trigger
or button operable to cut the target tissue and remove the target
tissue from abdomen A. For example, the first actuator 120 can be
utilized to couple the device 112 comprising the vacuum with the
end effector 101 as discussed in reference to FIGS. 2A and 2B.
According to other examples, the first actuator 120 can allow
electromagnetic energy in the form of current from the device 112
comprising the generator to directed to the end effector 101 to
provide for shape memory grasping or other type of manipulation of
the tissue including the endometrial tissue ET as discussed in
reference to FIGS. 3A and 3B.
[0051] FIGS. 2A and 2B show the tissue removal tool 100, and in
particular, a distal portion 130 of the shaft 116 and the end
effector 101. The end effector 101 can include a sheath 132, a
blade 134, a housing 136, a cavity 138 and a suction port 140. The
shaft 116 can include one or more passageways 142 including a
suction passageway 142A.
[0052] As shown in FIG. 2A, the sheath 132 can be positioned within
the housing 136 adjacent the shaft 116. The sheath 132 can be
configured to house the blade 134 in the retracted position shown
in FIG. 2A. The blade 134 can be positioned adjacent but spaced
slightly such as in a direction (indicated with arrows A1 and A2)
transverse to a longitudinal axis LA of the shaft 116 from the
housing 136 and the suction port 140, for example. The blade 134
can be movable within the cavity 138 from the retracted position of
FIG. 2A to the extended position of FIG. 2B. The cavity 138 can be
defined by the housing 136 and can be configured to receive
endometrial tissue ET (indicated with hatching) therein in addition
to other components including the sheath 132, the blade 134 and the
distal portion 130. The housing 136 can also define the suction
port 140, which can comprise an aperture or apertures extending
through the housing 136 and providing a passage from an exterior of
the end effector 101 to the interior the cavity 138. The suction
port 140 can be configured to receive the endometrial tissue ET and
allow for passage of at least a portion of the endometrial tissue
ET into the cavity 138.
[0053] In some examples, the end effector 101 can have a flexible
or semi-compliant portion 144. The portion 144 can be configured to
be movable relative to the shaft 116. Thus, the end effector 101
can be movable relative to the shaft 116 to interface (or abut))
with the background tissue BT that is adjacent to the endometrial
tissue ET. Put another way, the portion 144 can be configured to
allow the end effector 101 to be compliant with the background
tissue BT to seat thereon, according to some examples. Put another
way, the portion 144 can allow the end effector 101 to be movable
about at least an axis (generally corresponding with the arrows A1
and A2) transverse to the longitudinal axis LA of the shaft
116.
[0054] As shown in FIG. 2A, the end effector 101 can be configured
to gather the endometrial tissue ET relative to the background
tissue BT to a lifted position by application of suction from the
device 112 (FIG. 1) via the suction passageway 140A. Suction
passageway 140A can communicate with the cavity 138 to provide a
low pressure such as a vacuum to the cavity 138 and the suction
port 140. The suction provided to the cavity 138 and the suction
port 140 can be configured to lift the endometrial tissue ET by
gathering it within and into the suction port 140 and/or cavity 138
as shown in FIG. 2A.
[0055] Turning to FIG. 2B, the blade 134 is shown in the extended
tissue cutting position to cut and remove the endometrial tissue ET
from the background tissue BT. This can be done while the suction
discussed in FIG. 2A is applied. Thus, the end effector 101 can be
configured to cut the endometrial tissue ET from the background
tissue BT with the endometrial tissue in the lifted position by
receiving the endometrial tissue within the cavity 138 as
facilitated by the suction as shown in FIG. 2B. The end effector
101 can be configured to cut in a plane (co-planar with blade 134)
that is substantially parallel with a surface 150 of at least one
of the background tissue BT or the endometrial tissue ET, for
example. Such cutting arrangement can be facilitated by the portion
144 previously discussed, for example. As shown in FIG. 2B, the end
effector 101 can be configured to cut the endometrial tissue ET in
a direction transverse to a direction (corresponding to the
direction of arrows A1 and A2) in which the end effector 101 is
configured to lift the endometrial tissue ET.
[0056] It should be noted that although a blade (mechanical
facilitated cutting) is illustrated in performing the cutting of
FIG. 2B, it is contemplated in other examples that the cutting can
be performed in an energized manner (e.g., electromagnetic, laser
or another configuration or modality as known in the art).
Similarly, rather than cutting parallel with the longitudinal axis
LA, the blade can be configured to cut transverse to the
longitudinal axis or in another direction or can be rotatable such
as around the longitudinal axis LA or in another direction about
another axis. According to other examples, the tissue removal tool
can utilize the one or more passages 142 for various purposes such
as to suction the cut endometrial tissue ET away from the cutting
location. For example, the one or more passages 142 additional
extraction capabilities and/or tools. For example, the one or more
passages 142 can be used to morcellate or macerate tissue.
According to one example, an auger type device (not shown) can
reside in one of the one or more passages 142 and can extend out of
one of the ports thereof to remove tissue. The one or more passages
can be utilized for other purposes such as to freeze or cauterize
the background tissue BT after cutting, for example.
[0057] FIGS. 3A and 3B show another example of a tissue removal
tool 100'. The tissue removal tool 100' differs from the tissue
removal tool 100 of FIGS. 2A and 2B in that an end effector 101'
includes a shape memory element 200 configured to lift the
endometrial tissue ET by grasping and gathering as illustrated in
FIG. 3A. Thus, the port 140' of FIG. 3A does not comprise a suction
port formed by the housing 136 but is a receptacle formed at least
in part by the shape memory element 200 and used in conjunction
with the shape memory element 200 to receive the endometrial tissue
ET.
[0058] In other respects, the tissue removal tool 100' can be the
same as the tissue removal tool 100 of FIGS. 2A and 2B. Thus, the
end effector 101' can include the sheath 132, the blade 134, the
housing 136 and the cavity 138 as previously described. The shaft
116 can include the one or more passageways 142.
[0059] As shown in FIG. 3A, the end effector 101' can be configured
to lift the endometrial tissue ET relative to the background tissue
BT to a lifted position by application of current from the device
112 (FIG. 1) to cause the shape memory element 200 to actuate
(e.g., extend, change shape, curl, etc.). Alternatively, the shape
memory element 200 can change shape on its own due to a body
temperature of the patient, for example. Although the shape memory
element 200 is described in the singular it can comprise a
plurality of elements such as fingers, hooks, jaws or the like.
Further examples of shape memory elements 300, 400 and 500 that can
be utilized with the end effectors described herein are illustrated
in FIGS. 4A-6B. According to some examples, the shape memory
element 200 can be a nitinol material or another biologically
stable shape memory alloy or shape memory polymer as known in the
art. According to some examples, the shape memory element 200 can
be configured with one or more edges that can be become sharp (or
serrated) and capable of cutting the endometrial tissue ET when
actuated. According to some examples, the shape memory element 200
can include an electrically conductive element to facilitate
removal (e.g., monopolar or bipolar cutting). Alternatively,
cutting by the shape memory element 200, may be non-conductive as
discussed previously facilitated by serrated edge(s), sharpened
edge(s) or another feature of the shape memory element 200 or a
dedicated blade as in the previously illustrated examples.
[0060] As shown in FIG. 3B, the blade 134 is shown in the extended
tissue cutting position to cut and remove the endometrial tissue ET
from the background tissue BT. This can be done while the shape
memory element 200 is actuated to lift the endometrial tissue ET.
Thus, the end effector 101' can be configured to cut the
endometrial tissue ET from the background tissue BT with the
endometrial tissue in the lifted position as shown in FIG. 3B. As
illustrated in FIG. 3B, the end effector 101' can be configured to
cut the endometrial tissue ET from the background tissue BT by
receiving the endometrial tissue within the cavity 138 as
facilitated by the shape memory element 200. The end effector 101'
can be configured to cut in a plane (co-planar with blade 134) that
is substantially parallel with a surface 150 of at least one of the
background tissue BT or the endometrial tissue ET, for example.
Such cutting arrangement can be facilitated by the portion 144
previously discussed, for example. As shown in FIG. 3B, the end
effector 101' can be configured to cut the endometrial tissue ET in
a direction that is in a range of between about 45 degrees and
about 135 degrees, inclusive, to a direction (corresponding to the
direction of arrows A3 and A4 of FIG. 3A) in which the end effector
101' via the shape memory element 200 is configured to lift the
endometrial tissue ET. According to one example, the end effector
101' can be configured to cut the endometrial tissue ET in a
direction that is substantially transverse to a direction
(corresponding to the direction of arrows A3 and A4 of FIG. 3A) in
which the end effector 101' via the shape memory element 200 is
configured to lift the endometrial tissue ET. The end effector 101'
can be configured to gather the endometrial tissue ET in a
direction substantially transverse to or in another direction such
as one that is in a range of between about 45 degrees and about 135
degrees, inclusive, of a surface the background tissue BT (e.g.,
the direction can transverse to the surface 150 or at an angle to
the surface 150).
[0061] Although described with reference to the shape memory
element 200, in alternative examples it is contemplated that the
tissue removal tool could utilize other actuatable mechanisms for
lifting the endometrial tissue ET that are not shape memory in
configuration.
[0062] FIGS. 4A-6B show further examples of shape memory elements
that can be utilized with the end effectors discussed herein. These
and the shape memory element 200 of FIGS. 3A and 3B can be in an
undeformed state when unactuated and in a deformed state when
actuated. Examples of undeformed states are illustrated in FIGS.
3A, 4A, 5A and 6A. In the undeformed state, the shape memory
element(s) can be disposed on a plane that is generally parallel to
the plane defined the endometrial tissue and/or background tissue
(e.g., the plane defined by a surface of the endometrial tissue
and/or background tissue).
[0063] Examples of deformed states are illustrated in FIGS. 3B, 4B,
5B and 6B. In the deformed state, the shape memory element can wrap
around the endometrial tissue to facilitate removal thereof by
lifting (e.g., grasping, pulling, gathering, or the like). The
shape memory element can deform to the deformed state when
actuated. In the deformed state, the shape memory element can
include at a least portion or feature thereof (e.g., a finger or
slot) that can deform so as to be disposed along a plane
non-parallel to the background tissue (for example, the slots and
fingers of FIG. 6B can deform to form an angle of generally about
15-60 degrees, inclusive, relative to the plane along which the
background tissue is disposed (such plane can be defined by a
surface of the background tissue, for example).
[0064] FIG. 4A shows a schematic view of a shape memory element 300
comprising a finger 302 in an undeformed and unactuated state
positioned adjacent background tissue BT and endometrial tissue ET.
FIG. 4B shows a schematic view of the shape memory element 300 in
an actuated and deformed state and positioned relative to the
background tissue BT and endometrial tissue ET. FIGS. 4A and 4B are
views from a lift direction of the shape memory element 300. Thus,
as shown in FIG. 4B, the shape memory element 300 can be configured
to deform when actuated to curl around or wrap around at least a
portion of (or an entirety of) the endometrial tissue ET and/or
background tissue BT. With this curling the shape memory element
300 can be configured as a hook, for example. Additionally, the
curling of the shape memory element 300 can be substantially
transverse (or at another acute or obtuse angle) relative to the
lift direction (upward or downward into the page). Although
illustrated in two-dimensions, the curling can be in three
dimensions according to some examples. Thus, according to some
examples the shape memory element 300 can curl in further
directions into or out of the page of FIG. 4A that are not
specifically illustrated. The curling can be along one or more
surfaces of the endometrial tissue ET and/or background tissue BT,
for example. The curling can be into or around the endometrial
tissue ET and/or background tissue BT, for example. The curling can
be along a plane non-parallel with the background tissue BT so the
shape memory element 300 can be disposed along the plane
non-parallel to the background tissue BT. Thus, for example, an
angle of generally about 15-60 degrees, inclusive, can be formed
between the shape memory element relative to the plane along which
the background tissue BT is disposed (such plane can be defined by
a surface of the background tissue).
[0065] FIG. 5A shows a schematic view of a shape memory element 400
comprising a spatula 402 in an undeformed and unactuated state
positioned adjacent background tissue BT and endometrial tissue ET.
FIG. 5B shows a schematic view of the shape memory element 400 in
an actuated and deformed state and grasping the endometrial tissue
ET to remove it from the background tissue BT. As shown in FIG. 5B,
the shape memory element 400 can be configured to deform when
actuated to curl around or wrap around at least a portion of (or an
entirety of) the endometrial tissue ET and/or background tissue BT.
The shape memory element 400 can additionally be configured as the
spatula 402 to dig into the endometrial tissue ET and/or background
tissue BT in order to remove the endometrial tissue ET from the
background tissue BT as shown in FIG. 5B. With the curling of FIG.
5B, the shape memory element 400 can be configured as a hook, for
example. Additionally, the curling of the shape memory element 400
can be substantially transverse (or at another acute or obtuse
angle) relative to the lift direction. Although illustrated in
two-dimensions, the curling can be in three dimensions according to
some examples. Thus, according to some examples the shape memory
element 400 can curl in other directions such as into or out of the
page of FIG. 5A that are not specifically illustrated. The curling
can be along a plane non-parallel with the background tissue BT so
the shape memory element 400 can be disposed along the plane
non-parallel to the background tissue BT. Thus, for example, an
angle of generally about 15-60 degrees, inclusive, can be formed
between the shape memory element relative to the plane along which
the background tissue BT is disposed (such plane can be defined by
a surface of the background tissue).
[0066] FIG. 6A shows a schematic view of a shape memory element 500
comprising one or more slots 502 and one or more fingers 504 in an
undeformed and unactuated state positioned adjacent background
tissue BT and endometrial tissue ET. FIG. 6B shows a schematic view
of the shape memory element 500 in an actuated and deformed state
and grasping the endometrial tissue ET via the one or more slots
502 and one or more fingers 504 to remove the endometrial tissue ET
from the background tissue BT. As shown in FIG. 6B, the shape
memory element 500 can be configured to deform when actuated to
become angled to grasp at least a portion of (or an entirety of)
the endometrial tissue ET via passage of the endometrial tissue ET
through the one or more slots 502. Put another way, the shape
memory element 500 can be configured to deform to conform with the
background tissue BT and can be configured to receive the
endometrial tissue ET when deformed. Deformation of the shape
memory element 500 can be configured to lift the endometrial tissue
ET from the background tissue BT as shown in FIG. 6B. The
deformation of the shape memory element 500 can be substantially
transverse (or at another acute or obtuse angle) relative to the
lift direction. As shown in FIG. 6B, the deformation (angling of
the one or more fingers 504) can be along a plane non-parallel with
the background tissue BT so the shape memory element 500 can be
disposed along the plane non-parallel to the background tissue BT.
Thus, for example, as shown in FIG. 6B an angle ct of generally
about 15-60 degrees, inclusive, can be formed between the shape
memory element 600 relative to the plane along which the background
tissue BT is disposed (such plane can be defined by a surface of
the background tissue).
Various Notes
[0067] The above detailed description includes references to the
accompanying drawings, which form a part of the detailed
description. The drawings show, by way of illustration, specific
embodiments in which the invention can be practiced. These
embodiments are also referred to herein as "examples." Such
examples can include elements in addition to those shown or
described. However, the present inventor also contemplates examples
in which only those elements shown or described are provided.
Moreover, the present inventor also contemplates examples using any
combination or permutation of those elements shown or described (or
one or more aspects thereof), either with respect to a particular
example (or one or more aspects thereof), or with respect to other
examples (or one or more aspects thereof) shown or described
herein.
[0068] In this document, the terms "a" or "an" are used, as is
common in patent documents, to include one or more than one,
independent of any other instances or usages of "at least one" or
"one or more." In this document, the term "or" is used to refer to
a nonexclusive or, such that "A or B" includes "A but not B," "B
but not A," and "A and B," unless otherwise indicated. In this
document, the terms "including" and "in which" are used as the
plain-English equivalents of the respective terms "comprising" and
"wherein." Also, in the following claims, the terms "including" and
"comprising" are open-ended, that is, a system, device, article,
composition, formulation, or process that includes elements in
addition to those listed after such a term in a claim are still
deemed to fall within the scope of that claim. Moreover, in the
following claims, the terms "first," "second," and "third," etc.
are used merely as labels, and are not intended to impose numerical
requirements on their objects.
[0069] The above description is intended to be illustrative, and
not restrictive. For example, the above-described examples (or one
or more aspects thereof) may be used in combination with each
other. Other embodiments can be used, such as by one of ordinary
skill in the art upon reviewing the above description. The Abstract
is provided to comply with 37 C.F.R. .sctn. 1.72(b), to allow the
reader to quickly ascertain the nature of the technical disclosure.
It is submitted with the understanding that it will not be used to
interpret or limit the scope or meaning of the claims. Also, in the
above Detailed Description, various features may be grouped
together to streamline the disclosure. This should not be
interpreted as intending that an unclaimed disclosed feature is
essential to any claim. Rather, inventive subject matter may lie in
less than all features of a particular disclosed embodiment. Thus,
the following claims are hereby incorporated into the Detailed
Description as examples or embodiments, with each claim standing on
its own as a separate embodiment, and it is contemplated that such
embodiments can be combined with each other in various combinations
or permutations. The scope of the invention should be determined
with reference to the appended claims, along with the full scope of
equivalents to which such claims are entitled.
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